Agency Information Collection Activities: Proposed Request and Comment Request, 47845-47848 [2016-17259]
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ehiers on DSK5VPTVN1PROD with NOTICES
Federal Register / Vol. 81, No. 141 / Friday, July 22, 2016 / Notices
that there is a lack of current and
accurate information concerning the
securities of Scanner Technologies
Corp. (‘‘SCNI 1’’) (CIK No. 217222), a
revoked New Mexico corporation
located in Minneapolis, Minnesota with
a class of securities registered with the
Commission pursuant to Securities
Exchange Act of 1934 (‘‘Exchange Act’’)
Section 12(g) because it is delinquent in
its periodic filings with the
Commission, having not filed any
periodic reports since it filed a Form
10–Q for the period ended September
30, 2008. On January 29, 2016, the
Commission’s Division of Corporation
Finance (‘‘Corporation Finance’’) sent a
delinquency letter to SCNI requesting
compliance with its periodic filing
requirements but SCNI did not receive
the delinquency letter due to its failure
to maintain a valid address on file with
the Commission as required by
Commission rules (Rule 301 of
Regulation S–T, 17 CFR 232.301 and
Section 5.4 of EDGAR Filer Manual)
(‘‘Commission Issuer Address Rules’’).
As of July 14, 2016, the common stock
of SCNI was quoted on OTC Link
operated by OTC Markets Group Inc.
(formerly ‘‘Pink Sheets’’) (‘‘OTC Link’’),
had four market makers, and was
eligible for the ‘‘piggyback’’ exception of
Exchange Act Rule 15c2–11(f)(3).
It appears to the Commission that
there is a lack of current and accurate
information concerning the securities of
Seville Ventures Corp. (‘‘SVLE’’) (CIK
No. 1527424), a revoked Nevada
corporation located in Byron, Illinois
with a class of securities registered with
the Commission pursuant to Exchange
Act Section 12(g) because it is
delinquent in its periodic filings with
the Commission, having not filed any
periodic reports since it filed a Form
10–Q for the period ended April 30,
2014. On October 19, 2015, Corporation
Finance sent a delinquency letter to
SVLE requesting compliance with its
periodic filing requirements but SVLE
did not receive the delinquency letter
due to its failure to maintain a valid
address on file with the Commission as
required by Commission Issuer Address
Rules. As of July 14, 2016, the common
stock of SVLE was quoted on OTC Link,
had one market makers, and was eligible
for the ‘‘piggyback’’ exception of
Exchange Act Rule 15c2–11(f)(3).
It appears to the Commission that
there is a lack of current and accurate
information concerning the securities of
StarInvest Group, Inc. (‘‘STIV’’) (CIK No.
810270), a revoked Nevada corporation
located in Long Beach, New York with
1 The short form of each issuer’s name is also its
stock symbol.
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a class of securities registered with the
Commission pursuant to Exchange Act
Section 12(g) because it is delinquent in
its periodic filings with the
Commission, having not filed any
periodic reports since it filed a Form
10–K for the period ended December 31,
2010. On March 3, 2014, Corporation
Finance sent a delinquency letter to
STIV requesting compliance with its
periodic filing requirements but STIV
did not receive the delinquency letter
due to its failure to maintain a valid
address on file with the Commission as
required by Commission Issuer Address
Rules. As of July 14, 2016, the common
stock of STIV was quoted on OTC Link,
had five market makers, and was
eligible for the ‘‘piggyback’’ exception of
Exchange Act Rule 15c2–11(f)(3).
It appears to the Commission that
there is a lack of current and accurate
information concerning the securities of
The Digital Development Group Corp.
(‘‘DIDG’’) (CIK No. 1379699), a Nevada
corporation located in Los Angeles,
California with a class of securities
registered with the Commission
pursuant to Exchange Act Section 12(g)
because it is delinquent in its periodic
filings with the Commission, having not
filed any periodic reports since it filed
a Form 10–Q for the period ended
September 30, 2014. On November 30,
2015, Corporation Finance sent a
delinquency letter to DIDG requesting
compliance with its periodic filing
requirements but DIDG did not receive
the delinquency letter due to its failure
to maintain a valid address on file with
the Commission as required by
Commission Issuer Address Rules. As of
July 14, 2016, the common stock of
DIDG was quoted on OTC Link, had five
market makers, and was eligible for the
‘‘piggyback’’ exception of Exchange Act
Rule 15c2–11(f)(3).
The Commission is of the opinion that
the public interest and the protection of
investors require a suspension of trading
in the securities of the above-listed
companies. Therefore, it is ordered,
pursuant to Section 12(k) of the
Securities Exchange Act of 1934, that
trading in the securities of the abovelisted companies is suspended for the
period from 9:30 a.m. EDT on July 20,
2016, through 11:59 p.m. EDT on
August 2, 2016.
By the Commission.
Jill M. Peterson,
Assistant Secretary.
[FR Doc. 2016–17449 Filed 7–20–16; 11:15 am]
BILLING CODE 8011–01–P
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47845
SMALL BUSINESS ADMINISTRATION
Harbert Mezzanine Partners II SBIC,
L.P., License No. 04/04–0298; Notice
Seeking Exemption Under Section 312
of the Small Business Investment Act,
Conflicts of Interest
Notice is hereby given that Harbert
Mezzanine Partners II SBIC, L.P., 2100
Third Avenue North, Suite 600,
Birmingham, AL 35203, a Federal
Licensee under the Small Business
Investment Act of 1958, as amended
(‘‘the Act’’), in connection with the
financing of CDA, Inc., 8500 South
Tyron Street, Charlotte, NC 28273, has
sought an exemption under Section 312
of the Act and 13 CFR 107.730
financings which constitute conflicts of
interest of the Small Business
Administration (‘‘SBA’’) Rules and
Regulations. Harbert Mezzanine
Partners II SBIC, L.P. proposes to
provide debt financing to CDA, Inc.,
owned by Harbinger Mezzanine
Partners, L.P., an associate as defined in
13 CFR 107.50 of the SBA Rules and
Regulations. Therefore this transaction
is considered a conflict of interest
requiring SBA’s prior written
exemption.
Notice is hereby given that any
interested person may submit written
comments on the transaction, within
fifteen days of the date of this
publication, to the Associate
Administrator for Investment, U.S.
Small Business Administration, 409
Third Street SW., Washington, DC
20416.
Mark Walsh,
Associate Administrator, Office of Investment
and Innovation.
[FR Doc. 2016–17317 Filed 7–21–16; 8:45 am]
BILLING CODE P
SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA–2016–0033]
Agency Information Collection
Activities: Proposed Request and
Comment Request
The Social Security Administration
(SSA) publishes a list of information
collection packages requiring clearance
by the Office of Management and
Budget (OMB) in compliance with
Public Law 104–13, the Paperwork
Reduction Act of 1995, effective October
1, 1995. This notice includes revisions
and one extension of OMB-approved
information collections.
SSA is soliciting comments on the
accuracy of the agency’s burden
estimate; the need for the information;
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Federal Register / Vol. 81, No. 141 / Friday, July 22, 2016 / Notices
its practical utility; ways to enhance its
quality, utility, and clarity; and ways to
minimize burden on respondents,
including the use of automated
collection techniques or other forms of
information technology. Mail, email, or
fax your comments and
recommendations on the information
collection(s) to the OMB Desk Officer
and SSA Reports Clearance Officer at
the following addresses or fax numbers.
(OMB); Office of Management and
Budget, Attn: Desk Officer for SSA,
Fax: 202–395–6974, Email address:
OIRA_Submission@omb.eop.gov
(SSA); Social Security Administration,
OLCA, Attn: Reports Clearance
Director, 3100 West High Rise, 6401
Security Blvd., Baltimore, MD 21235,
Fax: 410–966–2830, Email address:
OR.Reports.Clearance@ssa.gov
Or you may submit your comments
online through www.regulations.gov,
referencing Docket ID Number [SSA–
2016–0033].
I. The information collections below
are pending at SSA. SSA will submit
them to OMB within 60 days from the
date of this notice. To be sure we
consider your comments, we must
receive them no later than September
20, 2016. Individuals can obtain copies
of the collection instruments by writing
to the above email address.
1. Request for Hearing by
Administrative Law Judge—20 CFR
404.929, 404.933, 416.1429, 404.1433,
418.1350, and 42 CFR 405.722—0960–
0269. When SSA denies applicants’ or
beneficiaries’ requests for new or
continuing benefits, the Social Security
Act entitles those applicants or
beneficiaries to request a hearing to
appeal the decision. To request a
hearing, individuals complete Form
HA–501, the associated Modernized
Claims System (MCS) or Modernized
Supplemental Security Income Claims
System (MSSICS) interview, or the
Internet application (i501). SSA uses the
Number of
respondents
Modality of completion
information to determine if the
individual: (1) Filed the request within
the prescribed time; (2) is the proper
party; and (3) took the steps necessary
to obtain the right to a hearing. SSA also
uses the information to determine: (1)
The individual’s reason(s) for
disagreeing with SSA’s prior
determinations in the case; (2) if the
individual has additional evidence to
submit; (3) if the individual wants an
oral hearing or a decision on the record;
and (4) whether the individual has (or
wants to appoint) a representative. The
respondents are Social Security benefit
applicants and recipients who want to
appeal SSA’s denial of their request for
new or continued benefits, and
Medicare Part B recipients who must
pay the Medicare Part B Income-Related
Monthly Adjustment Amount.
Type of Request: Revision of an OMBapproved information collection.
Average
burden per
response
(minutes)
Frequency
of response
Estimated
total annual
burden
(hours)
HA–501; Modernized Claims System (MCS); Modernized Supplemental Security Income Claims System (MSSICS) .....................................................
I501 (Internet iAppeals) ...................................................................................
25,953
643,516
1
1
10
5
4,326
53,626
Totals ........................................................................................................
669,469
........................
........................
57,952
2. Travel Expense Reimbursement—
20 CFR 404.999(d) and 416.1499—
0960–0434. The Social Security Act
provides for travel expense
reimbursement from Federal and State
agencies for claimant travel incidental
to medical examinations, and to parties,
their representatives, and all reasonably
necessary witnesses for travel exceeding
75 miles to attend medical
examinations, reconsideration
interviews and proceedings before an
administrative law judge.
Reimbursement procedures require the
claimant to provide: (1) A list of
expenses incurred, and (2) receipts of
such expenses. Federal and state
personnel review the listings and
receipts to verify the reimbursable
amount to the requestor. The
respondents are claimants for Title II
benefits and Title XVI payments, their
representatives, and witnesses.
Type of Request: Extension of an
OMB-approved information collection.
Modality of completion
Number of
respondents
Frequency
of response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
404.99(d) & 416.1499 ......................................................................................
60,000
1
10
10,000
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3. Request for Reconsideration—20
CFR 404.907–404.921, 416.1407–
416.1421, 408.1009, and 418.1325—
0960–0622. Individuals use Form SSA–
561–U2, the associated MCS interview,
or the Internet application (i561) to
initiate a request for reconsideration of
a denied claim. SSA uses the
information to document the request
and to determine an individual’s
eligibility or entitlement to Social
Security benefits (Title II), SSI payments
(Title XVI), Special Veterans Benefits
(Title VIII), Medicare (Title XVIII), and
Number of
respondents
Modality of completion
SSA–561 and Modernized Claims System (MCS) ..........................................
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for initial determinations regarding
Medicare Part B income-related
premium subsidy reductions. The
respondents are individuals filing for
reconsideration of a denied claim.
Type of Request: Revision of an OMBapproved information collection.
Average
burden per
response
(minutes)
Frequency
of response
550,370
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Estimated
total annual
burden
(hours)
8
73,383
47847
Federal Register / Vol. 81, No. 141 / Friday, July 22, 2016 / Notices
Number of
respondents
Modality of completion
Average
burden per
response
(minutes)
Frequency
of response
Estimated
total annual
burden
(hours)
I561 (Internet iAppeals) ...................................................................................
911,330
1
5
75,944
Totals ........................................................................................................
1,461,700
........................
........................
149,327
II. SSA submitted the information
collections below to OMB for clearance.
Your comments regarding the
information collections would be most
useful if OMB and SSA receive them 30
days from the date of this publication.
To be sure we consider your comments,
we must receive them no later than
August 22, 2016 Individuals can obtain
copies of the OMB clearance package by
writing to OR.Reports.Clearance@
ssa.gov.
1. Application for Supplemental
Security Income—20 CFR 416.207 and
416.305–416.335, Subpart C—0960–
0229. The Supplemental Security
Income (SSI) program provides aged,
blind, and disabled individuals who
have little or no income, with funds for
food, clothing, and shelter. Individuals
complete Form SSA–8000–BK to apply
Number of
respondents
Modality of completion
for SSI. SSA uses the information from
Form SSA–8000–BK and its electronic
intranet counterpart, MSSICS, to
determine: (1) Whether SSI claimants
meet all statutory and regulatory
eligibility requirements; and (2) SSI
payment amounts. The respondents are
applicants for SSI or their representative
payees.
Type of Request: Revision of an OMBapproved information collection.
Average
burden per
response
(minutes)
Frequency
of response
Estimated
total annual
burden
(hours)
SSA–8000–BK (Paper Version) ......................................................................
MSSICS/Signature Proxy ................................................................................
17,541
1,373,401
1
1
41
35
11,986
801,151
Totals ........................................................................................................
1,390,942
........................
........................
813,137
2. Medical Application for
Supplemental Security Income—20 CFR
416.305–416.335, Subpart C—0960–
0444. SSA uses Form SSA–8001–BK to
determine an applicant’s eligibility for
SSI and SSI payment amounts. SSA
employees also collect this information
during interviews with members of the
public who wish to file for SSI. SSA
uses the information for two purposes:
(1) To formally deny SSI for nonmedical reasons when information the
applicant provides results in
ineligibility; or (2) to establish a
Number of
responses
Modality of completion
disability claim, but defer the complete
development of non-medical issues
until SSA approves the disability. The
respondents are applicants for SSI.
Type of Request: Revision of an OMBapproved information collection.
Average
burden per
response
(minutes)
Frequency
of response
Estimated
total annual
burden
(hours)
MSSICS/Signature Proxy ................................................................................
Non-MSSICS (Paper) ......................................................................................
937,207
1,033
1
1
20
20
312,402
344
Totals ........................................................................................................
938,240
........................
........................
312,746
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3. Function Report—Child (Birth to
1st Birthday, Age 1 to 3rd Birthday, Age
3 to 6th Birthday, Age 6 to 12th
Birthday, Age 12 to 18th Birthday)—20
CFR 416.912 and 416.924a(a)(2)—0960–
0542. As part of SSA’s disability
determination process, we use Forms
SSA–3375–BK through SSA–3379–BK
to request information from a child’s
parent or guardian for children applying
for SSI. The five different versions of the
form contain questions about the child’s
day-to-day functioning appropriate to a
particular age group; thus, respondents
use only one version of the form for
each child. The adjudicative team
(disability examiners and medical or
psychological consultants) of State
disability determination services offices
collect the information on the
appropriate version of this form (in
conjunction with medical and other
evidence) to form a complete picture of
the children’s ability to function and
their impairment-related limitations.
The adjudicative team uses the
completed profile to determine: (1) If
each child’s impairment(s) results in
marked and severe functional
limitations; and (2) whether each child
is disabled. The respondents are parents
and guardians of child applicants for
SSI.
Type of Request: Revision on an
OMB-approved information collection.
Modality of completion
Number of
respondents
Frequency
of response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–3375; SSA-3376; SSA-3377; SSA-3378; SSA–3379 .............................
532,000
1
20
177,333
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Federal Register / Vol. 81, No. 141 / Friday, July 22, 2016 / Notices
4. Government-to-Government
Services Online Web site Registration;
Government-to-Government Services
Online Web site Account Modification/
Deletion Form—20 CFR 401.45—0960–
0757. The Government-to-Government
Services Online (GSO) Web site allows
various external organizations to submit
files to a variety of SSA systems and, in
some cases, receive files in return. The
SSA systems that process data
transferred via GSO include, but are not
limited to, systems responsible for
disability processing and benefit
determination or termination. SSA uses
the information on Form SSA–159,
Government-to-Government Online Web
site Registration Form, to register the
requestor to use the GSO Web site. Once
we receive the SSA–159, SSA provides
the user with account information and
conducts a walkthrough of the GSO Web
site as necessary. Established
organizations may submit Form SSA–
Number of
respondents
Modality of completion
159 to register additional users as well.
The established requesting
organizations can also complete Form
SSA–160, Government-to-Government
Online Web site Account Modification/
Deletion Form, to modify their online
accounts (e.g., address change).
Respondents are State and local
government agencies, and some private
sector business entities.
Type of Request: Revision of an OMBapproved information collection.
Average
burden per
response
(minutes)
Frequency
of response
Estimated
total annual
burden
(hours)
SSA–159 ..........................................................................................................
SSA–160 ..........................................................................................................
1,543
130
1
1
15
15
386
33
Totals ........................................................................................................
1,673
........................
........................
419
Dated: July 18, 2016.
Naomi R. Sipple,
Reports Clearance Officer, Social Security
Administration.
interest. I have ordered that Public
Notice of these Determinations be
published in the Federal Register.
BILLING CODE 4191–02–P
DEPARTMENT OF STATE
[Public Notice: 9648]
Culturally Significant Objects Imported
for Exhibition Determinations: ‘‘Every
People Under Heaven: Jerusalem,
1000–1400’’ Exhibition
Notice is hereby given of the
following determinations: Pursuant to
the authority vested in me by the Act of
October 19, 1965 (79 Stat. 985; 22 U.S.C.
2459), Executive Order 12047 of March
27, 1978, the Foreign Affairs Reform and
Restructuring Act of 1998 (112 Stat.
2681, et seq.; 22 U.S.C. 6501 note, et
seq.), Delegation of Authority No. 234 of
October 1, 1999, Delegation of Authority
No. 236–3 of August 28, 2000 (and, as
appropriate, Delegation of Authority No.
257–1 of December 11, 2015), I hereby
determine that the objects to be
included in the exhibition ‘‘Every
People Under Heaven: Jerusalem, 1000–
1400,’’ imported from abroad for
temporary exhibition within the United
States, are of cultural significance. The
objects are imported pursuant to loan
agreements with the foreign owners or
custodians. I also determine that the
exhibition or display of the exhibit
objects at The Metropolitan Museum of
Art, New York, New York, from on
about September 20, 2016, until on or
about January 8, 2017, and at possible
additional exhibitions or venues yet to
be determined, is in the national
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SUMMARY:
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For
further information, including a list of
the imported objects, contact the Office
of Public Diplomacy and Public Affairs
in the Office of the Legal Adviser, U.S.
Department of State (telephone: 202–
632–6471; email: section2459@
state.gov). The mailing address is U.S.
Department of State, L/PD, SA–5, Suite
5H03, Washington, DC 20522–0505.
FOR FURTHER INFORMATION CONTACT:
[FR Doc. 2016–17259 Filed 7–21–16; 8:45 am]
Dated: July 14, 2016.
Mark Taplin,
Deputy Assistant Secretary for Policy, Bureau
of Educational and Cultural Affairs,
Department of State.
[FR Doc. 2016–17395 Filed 7–21–16; 8:45 am]
BILLING CODE 4710–05–P
DEPARTMENT OF STATE
[Public Notice: 9647]
Culturally Significant Objects Imported
for Exhibition Determinations:
‘‘Breaking News: Turning the Lens on
Mass Media’’ Exhibition
Notice is hereby given of the
following determinations: Pursuant to
the authority vested in me by the Act of
October 19, 1965 (79 Stat. 985; 22 U.S.C.
2459), Executive Order 12047 of March
27, 1978, the Foreign Affairs Reform and
Restructuring Act of 1998 (112 Stat.
2681, et seq.; 22 U.S.C. 6501 note, et
seq.), Delegation of Authority No. 234 of
October 1, 1999, Delegation of Authority
No. 236–3 of August 28, 2000 (and, as
appropriate, Delegation of Authority No.
257 of April 15, 2003), I hereby
determine that the objects to be
included in the exhibition ‘‘Breaking
SUMMARY:
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News: Turning the Lens on Mass
Media,’’ imported from abroad for
temporary exhibition within the United
States, are of cultural significance. The
objects are imported pursuant to loan
agreements with the foreign owners or
custodians. I also determine that the
exhibition or display of the exhibit
objects at the J. Paul Getty Museum at
the Getty Center, Los Angeles,
California, from on or about December
20, 2016, until on or about April 30,
2017, and at possible additional
exhibitions or venues yet to be
determined, is in the national interest.
I have ordered that Public Notice of
these Determinations be published in
the Federal Register.
For
further information, including a list of
the imported objects, contact the Office
of Public Diplomacy and Public Affairs
in the Office of the Legal Adviser, U.S.
Department of State (telephone: 202–
632–6471; email: section2459@
state.gov). The mailing address is U.S.
Department of State, L/PD, SA–5, Suite
5H03, Washington, DC 20522–0505.
FOR FURTHER INFORMATION CONTACT:
Dated: July 13, 2016.
Mark Taplin,
Principal Deputy Assistant Secretary, Bureau
of Educational and Cultural Affairs,
Department of State.
[FR Doc. 2016–17396 Filed 7–21–16; 8:45 am]
BILLING CODE 4710–05–P
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]]>Agencies
[Federal Register Volume 81, Number 141 (Friday, July 22, 2016)]
[Notices]
[Pages 47845-47848]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-17259]
=======================================================================
-----------------------------------------------------------------------
SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA-2016-0033]
Agency Information Collection Activities: Proposed Request and
Comment Request
The Social Security Administration (SSA) publishes a list of
information collection packages requiring clearance by the Office of
Management and Budget (OMB) in compliance with Public Law 104-13, the
Paperwork Reduction Act of 1995, effective October 1, 1995. This notice
includes revisions and one extension of OMB-approved information
collections.
SSA is soliciting comments on the accuracy of the agency's burden
estimate; the need for the information;
[[Page 47846]]
its practical utility; ways to enhance its quality, utility, and
clarity; and ways to minimize burden on respondents, including the use
of automated collection techniques or other forms of information
technology. Mail, email, or fax your comments and recommendations on
the information collection(s) to the OMB Desk Officer and SSA Reports
Clearance Officer at the following addresses or fax numbers.
(OMB); Office of Management and Budget, Attn: Desk Officer for SSA,
Fax: 202-395-6974, Email address: OIRA_Submission@omb.eop.gov
(SSA); Social Security Administration, OLCA, Attn: Reports Clearance
Director, 3100 West High Rise, 6401 Security Blvd., Baltimore, MD
21235, Fax: 410-966-2830, Email address: OR.Reports.Clearance@ssa.gov
Or you may submit your comments online through www.regulations.gov,
referencing Docket ID Number [SSA-2016-0033].
I. The information collections below are pending at SSA. SSA will
submit them to OMB within 60 days from the date of this notice. To be
sure we consider your comments, we must receive them no later than
September 20, 2016. Individuals can obtain copies of the collection
instruments by writing to the above email address.
1. Request for Hearing by Administrative Law Judge--20 CFR 404.929,
404.933, 416.1429, 404.1433, 418.1350, and 42 CFR 405.722--0960-0269.
When SSA denies applicants' or beneficiaries' requests for new or
continuing benefits, the Social Security Act entitles those applicants
or beneficiaries to request a hearing to appeal the decision. To
request a hearing, individuals complete Form HA-501, the associated
Modernized Claims System (MCS) or Modernized Supplemental Security
Income Claims System (MSSICS) interview, or the Internet application
(i501). SSA uses the information to determine if the individual: (1)
Filed the request within the prescribed time; (2) is the proper party;
and (3) took the steps necessary to obtain the right to a hearing. SSA
also uses the information to determine: (1) The individual's reason(s)
for disagreeing with SSA's prior determinations in the case; (2) if the
individual has additional evidence to submit; (3) if the individual
wants an oral hearing or a decision on the record; and (4) whether the
individual has (or wants to appoint) a representative. The respondents
are Social Security benefit applicants and recipients who want to
appeal SSA's denial of their request for new or continued benefits, and
Medicare Part B recipients who must pay the Medicare Part B Income-
Related Monthly Adjustment Amount.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Modality of completion Number of Frequency of per response total annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
HA-501; Modernized Claims System (MCS); 25,953 1 10 4,326
Modernized Supplemental Security Income Claims
System (MSSICS)................................
I501 (Internet iAppeals)........................ 643,516 1 5 53,626
---------------------------------------------------------------
Totals...................................... 669,469 .............. .............. 57,952
----------------------------------------------------------------------------------------------------------------
2. Travel Expense Reimbursement--20 CFR 404.999(d) and 416.1499--
0960-0434. The Social Security Act provides for travel expense
reimbursement from Federal and State agencies for claimant travel
incidental to medical examinations, and to parties, their
representatives, and all reasonably necessary witnesses for travel
exceeding 75 miles to attend medical examinations, reconsideration
interviews and proceedings before an administrative law judge.
Reimbursement procedures require the claimant to provide: (1) A list of
expenses incurred, and (2) receipts of such expenses. Federal and state
personnel review the listings and receipts to verify the reimbursable
amount to the requestor. The respondents are claimants for Title II
benefits and Title XVI payments, their representatives, and witnesses.
Type of Request: Extension of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
404.99(d) & 416.1499........................ 60,000 1 10 10,000
----------------------------------------------------------------------------------------------------------------
3. Request for Reconsideration--20 CFR 404.907-404.921, 416.1407-
416.1421, 408.1009, and 418.1325--0960-0622. Individuals use Form SSA-
561-U2, the associated MCS interview, or the Internet application
(i561) to initiate a request for reconsideration of a denied claim. SSA
uses the information to document the request and to determine an
individual's eligibility or entitlement to Social Security benefits
(Title II), SSI payments (Title XVI), Special Veterans Benefits (Title
VIII), Medicare (Title XVIII), and for initial determinations regarding
Medicare Part B income-related premium subsidy reductions. The
respondents are individuals filing for reconsideration of a denied
claim.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Modality of completion Number of Frequency of per response total annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-561 and Modernized Claims System (MCS)...... 550,370 1 8 73,383
[[Page 47847]]
I561 (Internet iAppeals)........................ 911,330 1 5 75,944
---------------------------------------------------------------
Totals...................................... 1,461,700 .............. .............. 149,327
----------------------------------------------------------------------------------------------------------------
II. SSA submitted the information collections below to OMB for
clearance. Your comments regarding the information collections would be
most useful if OMB and SSA receive them 30 days from the date of this
publication. To be sure we consider your comments, we must receive them
no later than August 22, 2016 Individuals can obtain copies of the OMB
clearance package by writing to OR.Reports.Clearance@ssa.gov.
1. Application for Supplemental Security Income--20 CFR 416.207 and
416.305-416.335, Subpart C--0960-0229. The Supplemental Security Income
(SSI) program provides aged, blind, and disabled individuals who have
little or no income, with funds for food, clothing, and shelter.
Individuals complete Form SSA-8000-BK to apply for SSI. SSA uses the
information from Form SSA-8000-BK and its electronic intranet
counterpart, MSSICS, to determine: (1) Whether SSI claimants meet all
statutory and regulatory eligibility requirements; and (2) SSI payment
amounts. The respondents are applicants for SSI or their representative
payees.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Modality of completion Number of Frequency of per response total annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-8000-BK (Paper Version)..................... 17,541 1 41 11,986
MSSICS/Signature Proxy.......................... 1,373,401 1 35 801,151
---------------------------------------------------------------
Totals...................................... 1,390,942 .............. .............. 813,137
----------------------------------------------------------------------------------------------------------------
2. Medical Application for Supplemental Security Income--20 CFR
416.305-416.335, Subpart C--0960-0444. SSA uses Form SSA-8001-BK to
determine an applicant's eligibility for SSI and SSI payment amounts.
SSA employees also collect this information during interviews with
members of the public who wish to file for SSI. SSA uses the
information for two purposes: (1) To formally deny SSI for non-medical
reasons when information the applicant provides results in
ineligibility; or (2) to establish a disability claim, but defer the
complete development of non-medical issues until SSA approves the
disability. The respondents are applicants for SSI.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Modality of completion Number of Frequency of per response total annual
responses response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
MSSICS/Signature Proxy.......................... 937,207 1 20 312,402
Non-MSSICS (Paper).............................. 1,033 1 20 344
---------------------------------------------------------------
Totals...................................... 938,240 .............. .............. 312,746
----------------------------------------------------------------------------------------------------------------
3. Function Report--Child (Birth to 1st Birthday, Age 1 to 3rd
Birthday, Age 3 to 6th Birthday, Age 6 to 12th Birthday, Age 12 to 18th
Birthday)--20 CFR 416.912 and 416.924a(a)(2)--0960-0542. As part of
SSA's disability determination process, we use Forms SSA-3375-BK
through SSA-3379-BK to request information from a child's parent or
guardian for children applying for SSI. The five different versions of
the form contain questions about the child's day-to-day functioning
appropriate to a particular age group; thus, respondents use only one
version of the form for each child. The adjudicative team (disability
examiners and medical or psychological consultants) of State disability
determination services offices collect the information on the
appropriate version of this form (in conjunction with medical and other
evidence) to form a complete picture of the children's ability to
function and their impairment-related limitations. The adjudicative
team uses the completed profile to determine: (1) If each child's
impairment(s) results in marked and severe functional limitations; and
(2) whether each child is disabled. The respondents are parents and
guardians of child applicants for SSI.
Type of Request: Revision on an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-3375; SSA[dash]3376; SSA[dash]3377; 532,000 1 20 177,333
SSA[dash]3378; SSA-3379....................
----------------------------------------------------------------------------------------------------------------
[[Page 47848]]
4. Government-to-Government Services Online Web site Registration;
Government-to-Government Services Online Web site Account Modification/
Deletion Form--20 CFR 401.45--0960-0757. The Government-to-Government
Services Online (GSO) Web site allows various external organizations to
submit files to a variety of SSA systems and, in some cases, receive
files in return. The SSA systems that process data transferred via GSO
include, but are not limited to, systems responsible for disability
processing and benefit determination or termination. SSA uses the
information on Form SSA-159, Government-to-Government Online Web site
Registration Form, to register the requestor to use the GSO Web site.
Once we receive the SSA-159, SSA provides the user with account
information and conducts a walkthrough of the GSO Web site as
necessary. Established organizations may submit Form SSA-159 to
register additional users as well. The established requesting
organizations can also complete Form SSA-160, Government-to-Government
Online Web site Account Modification/Deletion Form, to modify their
online accounts (e.g., address change). Respondents are State and local
government agencies, and some private sector business entities.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Modality of completion Number of Frequency of per response total annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
SSA-159......................................... 1,543 1 15 386
SSA-160......................................... 130 1 15 33
---------------------------------------------------------------
Totals...................................... 1,673 .............. .............. 419
----------------------------------------------------------------------------------------------------------------
Dated: July 18, 2016.
Naomi R. Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2016-17259 Filed 7-21-16; 8:45 am]
BILLING CODE 4191-02-P
